白内障手术并发脉络膜上腔出血的原因分析

Risk Factors For Suprachoroidal Haemorrhage Complicating Cataract Surgery

目的:分析白内障手术中、术后发生脉络膜上腔出血的危险因素。方法:回顾性分析我院1 1例白内障手术并发脉络膜患者的全身、眼部和手术中的各项指标,并与40例无并发症发生的白内障手术患者相比较。结果:发生脉络膜上腔出血的危险因素包括:年龄(P<0.01)、心血管药物(P<0.01)、周围血管病变(P<0.05)、高脂血症(P<0.01)、青光眼(P<0.01)、术前高眼压(P<0.01)、Tenon’s囊内阻滞麻醉(P<0.01),局部麻醉(P<0.01),局部麻醉后压迫眶部(P<0.01)、后囊膜破裂(P<0.01)、白内障囊外摘除手术术式(P<0.05)。结果:发生脉络膜上腔出血的独立危险因素有:年龄、心血管药物、青光眼、术前高眼压、麻醉后未施行眶部的压迫和采用白内障囊外摘除手术。结论:研究显示有以上危险因素者发生脉络膜上腔出血的可能性较大,白内障术前、术后应控制这些危险因素以减少脉络膜上腔出血并发症的发生。

Objective：To analyse the risk factors for suprachoroidal haemorrhage（SCH）complicating cataract surgery.Methods：11 cases of SCH complicating cataract surgery were prospectively collected and compared with 40 controls that underwent cataract surgery.Their systemic,ophthalmic and operative variables were analysed.Results：Risk factors for SCH in this analysis included：older age（P〈0.01）,taking cardiovascular medication（P〈0.01）,peripheral vascular diseases（P〈0.05）,hyperlipidaemia（P〈0.01）,glaucoma（P〈0.01）,elevated preoperative intraocular pressure（P〈0.01）,sub-Tenon＇s local anaesthesia（LA）（P〈0.01）,topical LA（P〈0.01）,the lack of orbital compression following LA（P〈0.0 1）,posterior capsule rupture（P〈0.01）,extracapsular cataract extraction（ECCE）（P〈0.05）.Regression analysis showed the following independent risk factors：older age,taking cardiovascular medication,glaucoma,elevated preoperative intraocular pressure,the lack of orbital compression,elevated preoperative intraocular pressure and elective ECCE.Conclusion：The results showed patients at risk of SCH.Attention to the various modifiable preoperative and intraoperative risk factors is recommended in order to minimize the risk of SCH.